Acute respiratory failure and tracheal obstruction in patients with intrathoracic goiter

The surgical management of goiter: Part I. preoperative evaluation

“…The functional impact of airway narrowing diagnosed via CT scan remains controversial. Barker and others13, 22, 23 have noted that when CT scans show more than 50%–75% tracheal narrowing, airway symptoms are expected. However, Melissant and others19, 24 have found little correlation between lung function and CT scan defined degree of tracheal obstruction.…”

Posterior mediastinal goiters: Report of two cases and literature review

“…Features of phrenic nerve paralysis, Horner’s syndrome due to compression of the cervical sympathetic chain may be present too. Occasionally, patients suffer acute hemorrhage into the goiter which may cause sudden potentially fatal tracheal obstruction 5 . Rarely, jugular vein thrombosis, cerebrovascular steal syndrome or even superior vena cava syndrome have also been reported 6 …”

“…Pulmonary function tests, namely spirometry with flow-volume loops, may be abnormal even when the patient is asymptomatic 5 . Fixed upper airway obstruction from a substernal goiter, where flow is limited during both inspiration and expiration, results in a flattening of both limbs of the flow-volume loop.…”

Posterior Mediastinal Goiter

“…This 65-year-old woman had undergone subtotal thyroidectomy 30 esophageal posterior mediastinal goiters, and isolated mediastinal goiters with no significant cervical connection are best removed through a combined cervical and thoracic approach. The Lahey Clinic experience with three patients with posterior mediastinal goiter is described.…”